Epiglottitis - Causes, Symptoms & Treatment

Epiglottitis is inflammation of the cartilage that covers the trachea (windpipe). Due to its place in the airway , swelling of this structure can interfere with breathing and constitutes a medical emergency. A number of factors can cause the epiglottis to swell, including burns from hot liquids, a direct injury to the throat, and various viral and bacterial infections.

In the past, epiglottitis was most common in children 2 to 5 years old and was usually caused by the bacterium Haemophilus influenzae type b. Now that most children are vaccinated against Haemophilus influenzae type b, the disease is quite rare and is more common among adults. In adults, it is typically caused by Streptococcus pneumoniae , other streptococci, and staphylococci.

Children with epiglottitis often have bacteria in the bloodstream (bacteremia), which sometimes spreads the infection to the lungs, the joints, the tissues covering the brain (meninges), the sac around the heart, or the tissue beneath the skin.

Epiglottitis is an acute infection of the epiglottis, which is a flap of cartilage in the throat, at the entrance to the larynx. During the infection, the epiglottis rapidly swells, blocking the passage of air into the lungs.

The patient will experience difficulty breathing and, if not treated, the condition can be fatal. Therefore, if you suspect epiglottitis, you should treat it as an emergency and call 999 for an ambulance. Epiglottitis is also sometimes called acute supraglottitis. This refers to inflammation of the part of the windpipe above the voice box. Sometimes this part of the windpipe can get swollen and cause similar symptoms, without actually involving the epiglottis.

Causes of Epiglottitis

Epiglottitis involves bacterial infection of the epiglottis, most often caused by Haemophilus influenzae type B, although some cases are attributable to Streptococcus pneumoniae or Streptococcus pyogenes. Respiratory distress may be characterized by drooling, dyspnea, tachypnea, and inspiratory stridor develop rapidly, often causing the child to lean forward and hyperextend the neck to enhance air exchange. Swallowing problems may be associated with drooling. Epiglottitis is a life-threatening disease that begins with a high fever and very sore throat. Epiglottitis is a disorder caused by inflammation of the cartilage that covers the trachea. Difficulty breathing may cause the patient to sit up, leaning slightly forward and looking very anxious.

• Staphylococcus aureus.
• Group A and group C (ie, beta-hemolytic) streptococci.
• Candida albicans.
• Pseudomonas species.
• Haemophilus parainfluenzae.
• Although viruses normally do not cause epiglottitis, a prior viral infection may allow bacterial superinfection to occur. Viral agents may include herpes simplex, parainfluenzae, varicella-zoster, and Epstein-Barr.

Signs and Symptoms of Epiglottitis

Sometimes preceded by an upper respiratory tract infection, epiglottitis may progress to complete upper airway obstruction within 2 to 5 hours. Laryngeal obstruction results from inflammation and edema of the epiglottis. Accompanying symptoms include high fever, stridor, sore throat, dysphagia, irritability, restlessness, and drooling. The child often appears acutely ill, anxious, and has very quiet shallow breathing with the head held forward, insisting on sitting up in bed. The early symptoms are insidious but rapidly progressive, and swelling of the throat may lead to cyanosis and asphyxiation . Cases in adults are most typically seen amongst abusers of crack cocaine . George Washington is thought to have died of epiglottitis.

• Fever.
• Difficulty swallowing.
• Anxiety.
• Sore throat.
• Cough.
• Drooling.
• Chills, shaking.
• Voice changes (hoarseness).
• Difficulty breathing.
• Blue skin or lips.

Treatment for Epiglottitis

Treatment may include:

• Intravenous (IV) fluids, until the child can swallow again.
• Treatment usually involves the administration of humidified oxygen, which is oxygen that has been moistened to help the patient breathe. Oxygen therapy and arterial blood gas monitoring may be desirable.
• Hospitalization is required because this is an emergency situation. The patient is usually admitted to the intensive care unit.
• Steroid medication (to reduce airway swelling)
• Epinephrine have been used in the past. However, there is no good proof that these medications are helpful in cases of epiglottitis.

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